A Reader Asks: Which to do First – EMDR or Focusing?

I received this very interesting question and thought that you too might benefit from the answer.

Dear Mary,

I use to be a PTSD therapist, but I left the field many years ago. I’ve decided to come back to the field (after 16 years), but I want and need to do some training. I’ve been looking at Focusing and EMDR, would you have a recommendation of which one I should start with? I’ve doing a lot of research in these areas, but I’m feeling confused (I’m trying to get enough info. about both areas to make an educated decision). Would both (focus/emdr) benefit me? Do you use one more than the other (maybe they just hand-in-hand)? If I worked with a different population do you think both would be helpful? I greatly appreciate your time and help.

Thank you for your time, Elisheva Rabinowitz

Dear Elisheva:

That’s an interesting question, one I think a lot of people would be interested in.

For me, Focusing is the big picture in psychotherapy and EMDR is the surgical piece we bring in when we’re dealing with something that needs to affect the way the brain holds the trauma. As you’re aware, trauma therapy has changed a lot since you were in the field many years ago.In the old days we encouraged our patients and clients to go right into the trauma. Now we avoid re-traumatization at all costs. We also do a lot of preparatory work before beginning the trauma work and we discourage people from talking about their traumatic experiences.

That is why I would suggest starting with Focusing training. Focusing teaches a compassionate attitude towards oneself. It offers a way of working with resistance (seen as protection against something that was once too terrible to deal with) and with the inevitable shame and underlying fear that are inevitable in PTSD. If we follow the guiding principles of Focusing clients will access their traumatic memories as they are ready for them. As therapy progresses they will be gaining skills to use with themselves for the rest of their lives.

Focusing is body-based and the client learns to tap into the unconscious through the body’s physical responses to life’s situations. The therapy is uncontaminated by the therapist. What the client learns comes purely from the person in therapy, not from the “expert.”

All of this is an excellent training ground for Eye Movement Desensitization and Reprocessing.

To be effective, EMDR must also be uncontaminated by the practitioner. EMDR also depends on paying attention to the body’s response. It takes a lot of training to trust that the client knows the origin of the problem and where the healing lies. For me it was years before I fully believed I didn’t have to come up with solutions. Focusing is the best possible preparation for becoming an EMDR practitioner.

Until EMDR came along I had been doing trauma work with Focusing and other modalities. People improved greatly, but we never really moved them out of their deeply ingrained triggering when innocuous stimuli sent them into a state of terror. We didn’t know then about the role of the brain in PTSD. Now with EMDR we can change the way the brain holds the trauma!

Therefore, Elisheva, I recommend learning Focusing first. Once you feel skilled in Focusing, train in EMDR.